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Self-Esteem, Autism Symptoms, and Anxiety in Children and Adolescents with Autism Spectrum Disorders (ASD)
Background: In typical development (TYP), high self-esteem has been associated with many positive outcomes related to adaptive functioning, while low self-esteem has been associated with many negative ones including higher levels of social anxiety. Self-esteem in children and adolescents with ASD has been relatively understudied. Self-concept may develop atypically in such youths due to their impairments in social information processing, and therefore self-concept may exhibit a different relationship with anxiety than that found in TYP.
Objectives: The study had two main objectives: 1) to examine the association between self-esteem and social deficits in children and adolescents with autism spectrum disorders; 2) to examine the relationship between self-esteem and anxiety in youths with ASD.
Methods: Participants were 27 individuals aged 8-18 years (M:F ratio = 12:6) diagnosed with ASD based on the Social Communication Questionnaire (SCQ). They completed the Piers-Harris 2 (Piers, Harris, & Herzberg, 2002), and Screen for Child Anxiety Related Disorders (SCARED; Birmaher et al., 1995).
Results: 1) Total standard scores on the Piers-Harris ranged from 27 to 63 with a mean overall score within the normal range (M=46.259, SD=8.488). Of the six domains of self-esteem (Behavioral Adjustment, Intellectual and School Status, Physical Appearance and Attributes, Freedom from Anxiety, Popularity, Happiness and Satisfaction), the sample scored lowest and below age normed scores on Popularity, a measure of their social self-concept, and scored significantly higher on Happiness and Satisfaction (t=3.086, p=0.007, df=7). Popularity was positively associated with age (r=0.413, p<0.05). Greater social communication deficits as assessed by the SCQ were associated with lower levels of overall self-esteem (r=-0.432, p=0.024). 2) Participants with generalized, but not other forms of anxiety, had significantly lower self-esteem than those whose did not (t=3.402, p=0.004, df=15.522).
Conclusions: Although the population scored in the normal range for overall self-esteem, they exhibited below average scores on the Popularity domain of self-concept, suggesting that youths with ASD are concerned with how peers evaluate them. However, their score on the Happiness and Satisfaction subscale, which was found to be in the normal range, suggests there is a dissociation between their own social self-perceptions as indexed by the Popularity score and their overall well-being. Furthermore, scores in the Popularity domain increased with age. Also of clinical interest were findings that the presence of increased ASD symptoms and generalized anxiety were associated with poorer self-esteem. Future research is needed that better teases apart these relationships as they may have important implications for designing interventions that help adolescents with ASD.